GENERAL OBJECTIVES As a group, elderly individuals have a higher incidence and prevalence of functional vision impairments as a result of age related ocular changes. Since vision is a key component of driving, it is plausible that vision function may associated with driving performance. However, there is inadequate empirical information unequivocally linking age related vision changes to driving ability and traffic safety. The primary purpose of public policy requiring vision screening for driving licensure is to identify and when necessary, restrict drivers with functional vision impairments that exceed established minimal criteria In all states vision testing is required for the initial issuance of a driver license. However, vision testing is not required in all states for driver license renewal. This study will assess the impact of vision screening for driver license renewal on the frequency and severity of traffic crashes among elderly drivers. Secondarily, it will evaluate the individual and societal costs of such policies on the quality of life of older individuals. SPECIFIC AIMS Since elderly drivers have a higher prevalence of functional vision impairment, this age group should be most demonstrative of the efficacy of driver license renewal policies requiring vision screening in achieving this goal. This study will address the following questions: * Are the age-specific traffic crash rates of elderly drivers significantly lower in licensing jurisdictions requiring vision screening for driver license renewal? * Are the age-specific traffic crash fatality rates of elderly drivers significantly lower in licensing jurisdictions requiring vision screening for driver license renewal? * Are the age-specific traffic crash injury rates of elderly drivers significantly lower in licensing jurisdictions requiring vision screening for driver license renewal? * What effect do variations in screening policies (i.e., frequency of testing, types of tests performed, etc.) have on the frequency and severity of traffic crashes involving elderly drivers? Ideally, vision screening policies are effective in reducing the frequency and severity of traffic crashes, otherwise such policies may represent unnecessary quality of life barriers to elderly individuals. This project will ex lore the relative merits of such policies on senior citizens.